How is health insurance paid for patients who buy medicine themselves?

Legal Consulting Department of Lao Dong Newspaper answers:

Clause 1, Article 60 of Decree No. 188/2025/ND-CP detailing and guiding the implementation of a number of articles of the Law on Health Insurance stipulates the level of direct payment of costs to patients in cases where patients self-purchase medicines and medical equipment as follows:

1. Social insurance agencies pay directly to patients according to the following regulations:

a) For drugs: the basis for calculating the payment level is the quantity and unit price recorded on the invoice purchased by the patient at the pharmaceutical business establishment. If the drug has regulations on the ratio and conditions for payment, it shall be implemented according to the ratio and conditions for payment;

b) For medical equipment: the basis for calculating the payment level is the quantity and unit price recorded on the invoice purchased by the patient at the medical equipment trading establishment. In case medical equipment has a regulated payment level, the payment does not exceed the regulated payment level for that medical equipment.

Thus, patients who self-purchase medicines and medical equipment are directly reimbursed by the health insurance fund according to the above regulations.

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